Good health is the concern of any global citizen. Computerization has the potential to help automate many aspects of healthcare. Among them being automated recalls and reminders, decision support with “what-if” clinical problem solving and collaborative singular patient problem solving by a plurality of healthcare workers sharing a standard patient file that is functional across any computer operating system platform and computer network. Automation of healthcare is impaired by the lack of a viable universal transportable medical record that can fully encapsulate the total patient experience of all medical events and ongoing treatment and management of a patient. Patient's needs include prescriptive recalls for periodic health checks or management tasks based on specific disease diagnostic and management protocols.
In the internet era, where knowledge is supposed to flow freely, modern medicine is incongruent in the sense that medical knowledge is packaged in a manner that is incomprehensible to most. The medical decision making based on scientific facts available to the practitioners is often a process that totally excludes the input of the intelligent patient. This old paradigm, in the machine age, when patient has access to very comprehensive information on the world wide web, is possibly in need of transformation. Modern medicine has often exalted the elitism of the medical profession and has in the main rejected or downgraded the possibility of the patient helping to diagnose and solve his own problems. This has led to occasional patient frustration spilling over to litigation. The medical profession may have reacted and practice in a manner that is adapted to avoid litigation rather than providing best care. The cost of medical care is escalating in modern society for a number of reasons. Modern medicine has seen the proliferation of sophisticated laboratory and imaging test with its attendant costs. With the plurality of service providers, it is economic from the healthcare budget angle and in the patient's interest to not only avoid duplication of tests, but to do these tests intelligently with the help of software.
Increasingly the goal of medicine is evidence based medicine/best practice where the management is strictly set out in protocols with time components. An example of such a protocol is that regarding the management of diabetes mellitus. Nowadays the current best practice for management of diabetes mellitus requires:    1) initial referral to dietician and or diabetic educator;    2) twice a year glycated hemoglobin (HbA1c) tests;    3) annual review by opthamologist;    4) yearly checks for microalbuminuria;    5) yearly check by podiatrist; and    6) frequent home glucometer checking.
With increased societal affluence and educational level, citizens expect the best and optimal care. These factors conspire to drive up health costs.
Aggravating the situation are:    1) the existence of inefficiencies such as repeating unnecessary laboratory and imaging tests due to poor record keeping;    2) drug to drug interactions;    3) disease drug interactions;    4) poor analysis of symptoms and signs from the viewpoint of insufficient physician time;    5) restrictive work practice of the healthcare industry where the patient is locked out by an elitist medical profession: this often leads to a poorly informed patient;    6) poor decision making that is tainted/driven by litigation avoidance;    7) the lack of a collaborative framework whereby all healthcare workers and the patient can pool their resources together to help fix the patient's problems; and    8) the recent phenomenon of patient queries arising from medical knowledge gleaned from dredging the internet. This is a natural desire by intelligent and often internet savvy patients to “manage” their own medical conditions.
The doctor suffers the deluge of data generated by the practice of modern medicine; with the proliferation of tests and the need for tracking the results of these tests, drug adverse reactions and interactions. There has been a veritable data explosion in the field of medicine associated with real advances in medicine. But how do we convert all this data to knowledge and wisdom to impact favourably on the health of our patient?
In summary, the patient and the healthcare profession face the following problems:    1) Patient's poor understanding of his own overall health problems and lack of knowledge tools to dissect his medical conditions.    2) Patient's poor understanding and lack of access to reliable recordal means of the sequence of events such as laboratory and radiological tests relating to his health problems and inability to access his own record on the internet or computer network. In an ideal situation, the patient has the means to log on to his internet browser to find out his latest lipids results.    3) The patient is effectively disenfranchised from decision making, based on scientific facts relating to his health problems due to the lack of an “independent machine expert” working on his medical status based on his medical record. Hitherto, there is no effective electronic transportable medical record framework for decision making.    4) Attendant risks due to poor medical record keeping arising from the fragmented nature of medical care by multiple carers over time and geographical spread resulting in fractured medical records.    5) The lack of a write once, run anywhere computer medical record with built-in embedded health protocol commands, regardless of computer platform. The absence of an effective transportable electronic medical record capable of fully representing patient status and ongoing management tasks based on standards such as a text file of ASCII or even Latin-1 subset or UNICODE characters.    6) With the prior art, the medical records that are passive with data held in database fields, these data are aggregated/searched/processed and viewed by a process of SQL queries. This passive structure of current electronic medical record design is contrasted with the need for patient records to include active executive commands. This set of commands would need to be individually tailored to each patient.    7) With the prior art, the record keeping computer program analyses every record to see if a record qualifies for action to undertake preventive action/initiate medical action—for example, an adult woman is to seek a periodic pap smear and a periodic mammogram; a man over the age of 40 is to get his blood pressure checked every year. In the invention detailed here, the patient file has embedded commands individually tailored for each patient. Each individual command will each launch its own protocol.    8) Poor co-ordination among a multitude of health providers. In an ideal situation, a health provider such as the family physician or specialist should be able to get an accurate run down on a list of active problems, a list of medications, lists of imaging and non-imaging test results and other related health information; this is to avoid the repetition of a test in ignorance of the fact that it was recently done. The ideal medical record must be able to provide “in a nutshell ability”.    9) Current implementation of electronic medical records held in a network is plagued by privacy constraints. In this invention, the concept of headerless anonymous patient files written in medical scripting language is proposed as a way to obviate the problem.    10) Healthcare costs is aggravated by the time consuming nature of history taking and decision making. Significant cost savings can be derived if the patient can present a list of properly defined and analysed symptoms during consultation with the doctor and a comprehensive medical history and management work sheet arrived at by the patient himself using the client spreadsheet browser. His file written in medical scripting language and interacting with the supervisory program detailed in this invention.    11) With present electronic medical record systems, the consumer is locked out of the chance to view and have a say about his medical data, and is a passive element in the healthcare process.    12) A lack of access to a congruent set of patient data anywhere and anytime. The pervasive internet fulfils the criteria of being online everywhere and every time as long as the network is up. The invention detailed below leverages on this fact and allows decisiveness at the moment of choice in healthcare.
The ideal healthcare system must empower the patient. In this internet age, the advance of educational level, the interest in health matters by consumers—there is potential for a win-win partnership between the patient and the collection of stakeholders in the business of healthcare. This invention discusses the framework and implemented steps to bring this about.